The Department of Veterans Affairs may be ahead of many states and federal entities in administering the vaccine, but the complexity of deciding who is eligible for the vaccine and when it has left many confused and frustrated.
To date, the VA has administered 1.26 million doses of the COVID-19 vaccine; 305,197 veterans and officials received both doses by Monday.
To decide who has priority for the limited supply of vaccine, VA uses an algorithm to search its databases and prioritize veterans. But it also considers other factors, such as the local availability of vaccine doses, clinical resources and needs in each hospital or clinic and the number of COVID-19 infections in an area.
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VA officials say the approach has enabled the department to vaccinate large numbers of individuals in a relatively short period of time.
Some veterans, however, say they do not understand why they were not contacted, despite being what they believe to be considered “high risk”.
“My husband, a Vietnam veterinarian, was not contacted to receive the vaccine. … He is 77 years old and has health problems,” said the wife of a veteran in the Dallas-Fort Worth area who asked that his name not be was released because she wanted to keep her husband’s identity confidential.
He ended up getting an appointment in Dallas, not the North Texas VA Health System, she said.
“He had to wait in line for a car for four hours in Dallas to get the vaccine. It was tiring,” she added.
Others cited similar problems in other parts of the country.
“I am a combat veteran from Vietnam and I am 68 years old,” said Dave Moore of Columbia, South Carolina. “I am 100% VA deficient with two underlying conditions … Columbia VA has no idea.”
VA is using a software program called COVID-19 Vaccine Outreach for Veterans that analyzes information in the Veterans Health Administration Support Center’s databases to determine which patients are considered in high-risk groups.
The tool uses patient identifiers to weigh medical conditions, age and sex; it also indicates current treatments like chemotherapy or dialysis and other risk factors for severe COVID-19, such as smoking or obesity.
The system then provides a list of prioritized patients to local VA medical centers.
But these medical centers have their own set of conditions to consider when assessing the priority, according to VA spokesman Randy Noller.
“VA issued guidance on December 30, 2020, encouraging local flexibility to maximize access and efficiency of the COVID-19 vaccine and limit potential vaccine waste, and this guidance included flexibility to overlap and extend vaccination,” he said.
Individual VA health systems deal with factors that include vaccine hesitation, logistical challenges and their own patient lists prioritized by risk factors and location.
At the Veterans Affairs Medical Center in Anchorage, Alaska, for example, any veteran aged 60 or older is getting the vaccine.
And in Havre, Montana – a remote location where VA providers flew the vaccine to a one-day clinic on January 21 – 239 veterans of various ages were able to be inoculated.
“Montana is a very big state – 147,000 square miles. So we have a huge area to cover. We are also a mountainous state, so traveling in the winter can be a challenge between snow and small municipal roads. That’s why we are so thrilled to spread the vaccine across the state, ”said Judy Hayman, director of the VA Montana Health System.
According to Noller, the VA is largely ending efforts to vaccinate those classified as 1st – including health professionals, first responders and those living in residential communities – and move on to Phase 1b, or veterans aged 75 and over.
According to the Centers for Disease Control and Prevention, patients aged 65 to 74 are considered Phase 1c, as are those aged 16 to 64 with serious health problems.
But again, the priority can also be determined at the local level. As early as November, doctors at some VA health units began drawing up lists of high-risk patients for severe cases of COVID.
Vietnam veteran Wes Bickel, 73, receives his care at the VA Long Beach Healthcare System in California; he received a message on Saturday saying he had been identified as part of a priority group to receive the vaccine.
Bickel, who has a heart condition related to exposure to Agent Orange, received his first dose the day before in his county, ending several weeks of frustration with VA.
“Some of my teammates have joined the queue and have already received their second attempts. … I am happy to have options and to register with the county and not just depend on VA,” Bickel told Military.com.
VA Long Beach had such a strong response from area residents – including non-veterans – wanting the vaccine that the facility’s phone system went down due to pressure from calls last week.
“We know that the process for getting vaccines has been frustrating even under the best of circumstances, and not being able to contact us just adds to that. Be patient with us as we all navigate the COVID-19 pandemic,” officials wrote on Friday in a warning. veterans.
The VA is “using all means to vaccinate as many veterans and staff as possible as quickly as possible,” according to Noller, and the process should go more smoothly when more vaccines are available.
“We have built a system ready to accommodate much larger quantities as manufacturers move forward. I am incredibly satisfied,” said Dr. Richard Stone, VA’s undersecretary of health.
Even as VA’s vaccination effort has grown, officials are telling veterans that if they have the opportunity to register for the vaccine elsewhere, they should do so.
“We want to encourage veterans to get the COVID vaccine as soon as it is available to them,” said Dr. Sophia Califano, VA’s deputy chief consultant for preventive medicine, in a statement. “We believe this is the best way forward and the best way to protect you and your family.”
– Patricia Kime can be contacted at [email protected]. Follow her Twitter @patriciakime.
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